Breast Augmentation Implants 6 months post op Bottom Out and Lateral Displacement?

I feel like my breasts are too far apart & are too bottom heavy with nipples too high up with scars in fold now riding up. Am I bottoming out with lateral displacement? I was a 32a pre surgery, had 275cc smooth silicone implants under the muscle moderate profile (post-op a 34c). If I decide to revise, should I get an internal bra, textured implants, change to higher profile or just have the pockets tightened? Could the implants shifted because I went too large? Can the gap be decreased? Thanks!

Doctor Answers 11

Breast Augmentation Implants 6 months post op Bottom Out and Lateral Displacement?

It does appear that you have bottoming out of the implants.  The lateral placement of the implants may be due to the diameter of the implants and your natural breast diameter and not necessarily lateral displacement.  You certainly can get more cleavage, but because you are thin and have naturally small breasts, you may have rippling in the medial aspect of your breasts if you try to get more cleavage or you choose to go with a significantly larger implant.  I don't necessarily recommend going with a higher profile implant, that may actually only make your gap larger or at best the same as it is now.  You would benefit from an in person exam so that your options can better be explained after a thorough breast exam. To decrease the gap in the cleavage you would need a larger base diameter implant.  To correct the bottoming out, you would need a capsulorraphy, internal suturing of the lower aspect of your breasts, and perhaps the outer aspect, depending on the final size of implant that you would be choosing.  Good luck!  

Newport Beach Plastic Surgeon
4.9 out of 5 stars 107 reviews

Wide cleavage

Every woman has different space dimentions in their cleavage area, and in your particular case, it seems that you were born with a wide cleavage.  Your augmentation looks very good, and if you were going to have a revision, your surgeon could use somewhat larger implants to decrease the space between your breasts.

Malcolm A. Lesavoy, MD
Beverly Hills Plastic Surgeon
3.9 out of 5 stars 11 reviews

Bottoming out

Thank you for the photos they confirm your suspicions. The high riding incision is an indication that the breast fold has been lowered. The correction for this can be done with suture techniques to close the space and restore the fold to its normal position.As far as the cleavage is concerned that is difficult to say from the photos. This is determined by the muscle attachment to the breast bone. A more projecting implant can help with the perception of cleavage even if the implants can not be placed closer together.Seek out a board certified plastic surgeon to evaluate you and give more detailed information on how to best proceed.Good luck and I hope this was helpful.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

Implant Malposition

Your photos demonstrate inferior and lateral displacement of your implants. This can be corrected by closing-down the pocket to shift the implants to a more medial and superior location. Because the nipple/areola move opposite that of the implants, this will bring their position down. Also, the incision scars should move downward toward the fold, where they will be less visible. This correction can be performed with or without the addition of any number of reinforcing materials to add strength to the repair. The implants themselves do not appear to be too large at all for your frame size, based on your photos. I hope that this is helpful. Best of luck with your corrective surgery.

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 18 reviews

Bottoming out

You have a very common issue that the fix has a high rate of success. My recommendation would be to perform a lateral and inferior capsulorrhaphy (suturing the pocket on the sides and bottom) and an implant exchange to larger smooth round silicone implant. Find a board certified plastic surgeon in your area that has extensive experience in these types of surgeries. Best of luck to you.

Paul E. Chasan, MD
Del Mar Plastic Surgeon
4.9 out of 5 stars 40 reviews

Breast Augmentation Implants 6 months post op Bottom Out and Lateral Displacement?

No, you did not go too big, the problem is that the pockets are too big for the implants. You will need to have the pockets closed both at the bottom and side of each breast. You should have no problem in keeping the same implants. Just be sure you see a very experienced and skilled surgeon to correct the problem. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews


Thank you for the photos and questions and sorry for your problem.  The good news is that it can be fixed so see some experts in your area 
Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 reviews

Implants moving to the side and falling....what to do?

Thank you for your question and reviewing your concerns.  Smooth silicone implants can work very well for most patients.  There is a subset of patients, however, in which the implants settle excessively and fall laterally (to the side).  This is more likely to happen if you had limited supportive breast tissue or stretchable skin.  It is also more likely to occur if your ribcage angles outwards, because the implants will always want to follow the angulation of the chest.  When you lay down, the implants will want to stretch the side of your breasts and stretch-out the pocket.Sometimes, a capsulorrhapy is all that is needed to improve your situation.  In this procecure, the doctor will tighten and reduce the size of your pockets such that the implants move up and in.  The capsulorrhapy can be strengthened with a supportive material such as Seri (silk mesh) or ADM.    Textured implants can be helpful, but require a moderate amount of breast tissue to conceal (to avoid wrinkling).  I would recommend speaking to your doctor about your concerns and you should get some good options.  Best wishes!

Stephen Bresnick, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 32 reviews


You have malposition with bottoming out that will require capsular sling and tightening of the inframammary fold. Seek a breast revision specialist in your area. 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 42 reviews

Breast Augmentation Implants 6 months post op Bottom Out and Lateral Displacement?

I am sorry to hear about your concerns after breast augmentation surgery. Based on your description and photographs (which demonstrate your concerns nicely), it is likely that you are dealing with a breast implant displacement issue;  the breast implants are moving too inferiorly when you stand and off to the sides when you lie down. The procedure that will likely improve your situation is called capsulorrhaphy;  this procedure involves the use of sutures internally along the breast implant capsule, surrounding the breast implants. It involves decreasing the space surrounding the breast implants, by removing some of the capsule tissue and re-suturing the excised edges.  In my practice, this repair is done with a 2 layered suture technique. The use of acellular dermal matrix is an option,  depending on patient physical examination and history, especially if significant implant rippling/palpability is present.

In other words, the "volume" of the  capsule (scar) tissue space surrounding the breast implant is decreased in size. This procedure is commonly performed to treat breast implant displacement or malposition concerns such as lateral displacement (breast implants “falling” off to the sides), bottoming out of breast implants, and/or symmastia. The procedure may also be helpful when patients are downsizing breast implants.   I hope this, and the attached link (dedicated to revisionary breast surgery concerns, helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.